FACT: Privatization is the only sustainable future for canadian healthcare.

[A-Stark]

ARGH anyone who dares to disagree with the way the Canadian health care system is run and wants to see it privatized must be an ignorant troll and should be banned. That's the Canadian way always has been. Free speech is for those American *******s.

 

Anyone who starts off by stating that "communism/socialism/liberalism/leftism" can be conflated and "don't work" isn't worth comment. The notion that privatization "costs nothing" is laughable. And while I agree that someone with a 90 pack year Hx requiring a total laryngectomy and ICU care did not "take care" of his body, I cannot see any ethical justification for denying them appropriate care - which, incidentally, doesn't really "fix" anything. While there are substantial financial costs for "self-inflicted" illness, the cost in terms of individual morbidity and mortality is altogether greater and more terrible.

 

Although I wouldn't recommend leaving the elderly helpless, some of the points this guy makes are spot on. Also, privatization is something that WILL happen in Canada sooner or later to some degree.

 

Which points would those be? And what do you mean by "privatization"? Which services would you like to see delisted? As it stands some 30% of health care is privately funded and a greater percentage is privately delivered. What sort of extra-billing by physicians should be tolerated? Is that ethical? I'm tired of hearing empty comments calling for non-specific "privatization" without any regard to what WILL WORK or IMPROVE care on issues like costs or access. Because there is NO EVIDENCE whatsoever that there are any cost or quality benefits to privatization. But then the would-be privatizers aren't really interested in evidence.

 

yes, though, it would be dumb to go to a total privatized system...we need to be able to strike a balance...and im not kidding when i think that those who are able to better pay off their treatment (the rich, or those above a certain income bracket) be made to pay for some of the healthcare costs...i think that treatments themselves should be clumped into different sets based on costs as well as persons in different income brackets...there should then be a matching process to determine if person from income bracket A can payoff for treatment from set B...then there maybe certain treatments such as cancer which, unfortunately, could run life-long and i believe that in such situations again, there must be a determination of how much a person can payoff without having to go on the street (and maintain the degree of comfortable lifestyle, given their unhealthy circumstance)..offcourse the tax payer should chip in but if the person is sitting on a gold chest, then theres something inefficient

 

The "rich" already pay considerably more for their healthcare costs via higher taxes. This is a moot point. And essentially what you're calling for is a huge US-style insurance bureaucracy, up to and including odious concepts like lifetime maximum benefits.

 

To take a complicated example, based on income bracket we might have to treat one septic patient with imipenem and another one with something cheaper. Cost issues should factor in care decisions but not in a way that adversely affects patient care. That is not a negotiable principle for me.

 

I actually do kind of agree re: statements about elder care. Anybody who has spent time in LTC facilities can attest to the terrible conditions and how many of the residents are simply "empty shells". When we think of the huge amounts of money sunk into providing this care, it raises some interesting questions.

 

Fortunately newer LTC facilities are being constructed and maintained to much higher standards. "Empty shells" may not be an entirely inaccurate way to put it, but this isn't directly relevant to funding or delivery of acute or primary care.

[MarathonRunner]

A mixed system, of both public AND private health care, like they have in Germany, works best, IMO.

 

When I lived in Germany I never had to wait to see a doctor. I was able to find a family doctor, who spoke English, with absolutely no difficulty! Contrast that to here in Canada, where upon moving back from Germany, I have yet to find a family doctor. To see my family doctor in Germany, I could either make an appointment, or show up during his "office hours" - if I did that, I never had to wait more than an hour to see him. Contrast that to Canada, when I did have a family doctor when I lived in a different city, where I had to wait over a week to receive an appointment, and then, even when I had an appointment, often had to wait over an hour to finally get in to see her!

 

Also in Germany, I never had to wait more than 48 hours to see a specialist or to have a diagnostic test done (MRI, CT scan). Contrast that to Canada, where I have had to wait over 6 months to see a specialist, and then another 6 months for surgery! (For stage 4 endometriosis, if you are curious, which was causing me daily pain and totally incapacitating me during my period). In Germany, when it started acting up, I was able to see a "Frauenartz" (gynaecologist) two days later!

 

Germany has a mix of public and private health care. Most family doctors and specialists take both public and private insured patients, and you receive the same treatment, whether you have public or private health insurance. Now, if you are employed, you do have a portion of your salary going towards that insurance (it is automatically taken off) - basically you pay half and the government pays half, if you make above a certain threshold. If you don't make that much, or are unemployed, the government insurance provides for you.

 

Some people, though, have totally private insurance through their employer. That's what I had in Germany. I didn't pay anything into it directly - it was part of the employment benefits (no doubt I paid indirectly into it somehow). All of my medical expenses for doctors, diagnostic tests, and procedures, was fully covered. 80% of the cost of my prescriptions was covered. Vision and dental was covered at the same 80%.

 

I think Canada's health care system, as it currently exists, is broken. I think we need to fix it. I also think we should be looking at a mixed system, like Germany and many other European nations have. Private health care doesn't have to mean and American model. A mix of public and private, that makes sure that ALL people are taken care of, can work very well. I've seen it in action, first hand, in Germany.

[psychoswim]

Is the health care system different in QC vs elsewhere in Canada? I know I've paid before to get an MRI in a private clinic so it would be much faster. My mom works at the WSIB in Ottawa (workplace safety) and she regularly sends clients to have surgery in private clinics in Montreal since it's so much faster and covered by some insurance plans. My ortho surgeon has 1 OR day per week in the 2 hospitals where he's staff, and another day at a private clinic as do many others now.

 

I'm honestly not very well versed in how it is outside here as it's often so different :/

[A-Stark]

I think health care is hardly the only thing we could stand to emulate from Germany (public transit, rail... essentially every area of infrastructure, labour relations).

 

Interestingly, a higher percentage of total health care expenditures in Germany is public compared to Canada (77% to 71%). We already have a significant mix of public and private spending in health care in Canada - the trick is that while Germany (and others) spends publicly on everything from hospital to dental care, we offer only patchwork coverage for drugs, physio, and optometry, very little for dental, and cover about 99% of all physician billings publicly. I don't think this is especially important for differences in access - that probably has more to do with Germany's 3.6 physicians per 1000 people compared to Canada's 2.4. And my month in an Austrian hospital matches the 4.8 per 1000 there.

 

And total hospital beds per 1000? In Germany: 8.2. Canada? 3.3. Acute care beds? 5.7 and 1.8, respectively, in 2008. And in Canada that's down from 3.9 per 1000 in 1995.

 

In other words, we have utterly depleted our health care (human and physical) resources, not that they were ever as good as Germany. Want wait times and access to improve? We'll need more acute care beds, more physicians, more nurses, more resources in pretty much every respect. Privatization won't give us any of that, but it will shift costs from the (mildly progressive) tax base to out-of-pocket expenses (14.6% of the total in Canada vs. 13.1% in Germany) and private insurance, both of which are already greater per capita and proportional expenditures in Canada than in Germany.

 

(Data from here)

 

So, I'm not quite sure what the solutions are, but demanding that people pay more out of pocket (which WILL disproportionately hit lower and middle income earners) or buy private insurance they are not. On the other hand, we've had over a decade of income, capital, and corporate tax breaks, especially federally, where in 1995 unprecedented billions were cut from health and education transfer payments... and we wonder why all forms of public infrastructure seem to be suffering from chronic underinvestment and operation funding.

 

(As a historical note, the TTC used to receive a significant proportion of its funding from the province. Another fine legacy of the "Common Sense" Revolution was the end of that funding, along with the selloff of the 407 and cancellation of subway expansion - apart from Sheppard of course.)

[A-Stark]

Is the health care system different in QC vs elsewhere in Canada? I know I've paid before to get an MRI in a private clinic so it would be much faster. My mom works at the WSIB in Ottawa (workplace safety) and she regularly sends clients to have surgery in private clinics in Montreal since it's so much faster and covered by some insurance plans. My ortho surgeon has 1 OR day per week in the 2 hospitals where he's staff, and another day at a private clinic as do many others now.

 

I'm honestly not very well versed in how it is outside here as it's often so different :/

 

The WSIB system predates medicare and is an example of a separate parallel system. This is true across the country.

[psychoswim]

The WSIB system predates medicare and is an example of a separate parallel system. This is true across the country.

 

Ah thank you!

[Wayward son]

I agree that public funding for healthcare is not sustainable, A geneticist from the Children's Hospital here told me that enzyme replacement therapy can cost about $750,000 per person (not sure if that was annually or not).

 

One would think that like so many other things the price will go down considerably over time. As for publicly funded health care not being sustainable - why not? We have plenty of options to restructure the way health care is delivered without removing the public funding. I can see if someone actually wants to end the public funding, but those who simply feel that it is inevitable are lacking in forward thinking as to the options that exist.

[Wayward son]

ARGH anyone who dares to disagree with the way the Canadian health care system is run and wants to see it privatized must be an ignorant troll and should be banned. That's the Canadian way always has been. Free speech is for those American *******s.

 

Boy are you ever going to mad when you go the the US and discover that free speech there is protection from the government and has nothing to do with the limitations that private organizations and webforums place on their users.

 

Although I wouldn't recommend leaving the elderly helpless, some of the points this guy makes are spot on. Also, privatization is something that WILL happen in Canada sooner or later to some degree.

 

Although AS already covered this well, I am too am interested in what points he made that are spot on?

 

Was it the childishly incorrect view of evolution on a social species? The mindnumbingly stupid claim that going into the jungle would show you what your rights are? The economically ignorant claims?

 

Personally I oppose D.K. being banned or censored. I hope that he posts here enough that every medical school can determine who he is when he applies.

[RyanMaverick]

And total hospital beds per 1000? In Germany: 8.2. Canada? 3.3. Acute care beds? 5.7 and 1.8, respectively, in 2008. And in Canada that's down from 3.9 per 1000 in 1995.

 

I think there's an important difference between Germany and Canada that needs to be addressed. Germany is a relatively condensed European country, while Canada is a vast, spread out country with many smaller towns. It'd certainly be much more cost effective to have fewer large centers rather then the mish-mash of, largely, inefficient community hospitals that are present in some areas of the country - particularly the north.

 

I'm not trying to derail your point as I think it's a good overall number to compare access, but we should keep in mind that we face a lot different challenges with respect to delivery of care than a European country such as Germany might.

[Robin Hood]

Here's the problem. Communism/socialism/liberalism/leftism/etc, in any form, doesn't work. That includes for healthcare.

 

But allow me to be more specific.

 

1) When people don't pay for their healthcare, they start treating their bodies like ****, because they know they'll be able to get fixed for free. This overloads the system. If people had to pay to get fixed, maybe they wouldn't be so wreckless? This isn't fair to people who exercise and eat right, and don't have genetic defects. Let's let natural selection work for us.

 

2) When people get free healthcare, they abuse the system. Ouch, I scraped my knee, off to the doctor, cause it's free! If you had to pay, there would be a lot less of this.

 

3) Too many old people. These people contribute little to the economy, there is no reason, other than altruism, to support them for free.

 

4) Healthcare isn't a right. You want to know what your rights are? Go live in the jungle for a month, you'll learn your "rights" very quickly. Can't afford it? Too bad, you should have put some money in the bank instead of blowing it on that big screen TV or that house you couldn't afford. Natural selection, again.

 

5) Here's why privatization is sustainable. It doesn't cost taxpayers anything. There, problem solved.

 

If your selfish and don't care about other human beings then your place is not among them but in the jungle.

[NLengr]

Anyone who starts off by stating that "communism/socialism/liberalism/leftism" can be conflated and "don't work" isn't worth comment.

 

I pretty much read to the "communism/socialism/liberalism/leftism" part, and then stopped. People making comments like that are quickly identifying themselves as full of right wing hot air, plenty of classic right wing derp and little knowledge.

 

For the OP though:

 

[rmorelan]

 

PPS, banning me for my opinions of healthcare is the digital equivalent of murder-censorship. Nobody should get banned for what their write, period.

 

By that logic no one should ever get banned I assure you that is not the case.

 

We allow postings that inform the debate, we allow posting that inspire debate, and we allow postings to promote community on the forum.

[A-Stark]

I think there's an important difference between Germany and Canada that needs to be addressed. Germany is a relatively condensed European country, while Canada is a vast, spread out country with many smaller towns. It'd certainly be much more cost effective to have fewer large centers rather then the mish-mash of, largely, inefficient community hospitals that are present in some areas of the country - particularly the north.

 

I'm not trying to derail your point as I think it's a good overall number to compare access, but we should keep in mind that we face a lot different challenges with respect to delivery of care than a European country such as Germany might.

 

I don't agree. Germany may be a more densely populated - and more populated period - country, but I'm not sure that makes it easier to have three times more acute care beds per 1000 people. Arguably the greatest problems with resources and capacity in Canada are not in remote areas per se, but in fast-growing urban (and suburban) centres. Resources have simply not kept pace with population growth/changes.

[MarathonRunner]

Well, Germany is obviously doing *something* right, since they spend close to the same, per capita, on health care as Canada does (although overall they spend a little less, per capita, than us), yet, from a patient's perspective (and from the few doctors I spoke with), their system is far superior to Canada's. I think there are things we could learn from the German system. I'm not saying that replicating it would work in Canada, but I'm almost positive there are things we could certainly learn from them.

[D.K.]

Before I explain why privatization is better, let me explain the current state of affairs.

 

In the government run system we currently have, the government acts as a monopoly controlling all access to healthcare.

 

In a completely privatized system, various corporations or business owners would own hospitals. When you want healthcare, you pay them money.

 

Now allow me to explain why a privatized system is better.

 

1) Government is less efficient, inherently, than privately run businesses.

 

Why is this? When the government runs a business, usually it's the only one in town. There is no competition. This takes away any real incentive for improvement. In a privatized healthcare industry, the 3 hospitals in town would be competing with each other to drive down costs, make service better for patients, and reduce wait times to get as many patients through the doors as possible to make the most amount of money.

 

You could argue that voters can pressure politicians to make the healthcare system more efficient in a government-run system. But in this case, the competition is at a more indirect level (politican vs. politician instead of hospital vs. hospital) so the results won't be as "real." We all know how good politicians are at making things happen. As bad as things are, the pressure on the hospitals just isn't there right now, because at the end of the day, the people running them know that even if they aren't doing the best job the can do, they still come home with a paycheck. Such is not the case in the business world.

 

You could also argue that in a private healthcare industry, the owners of the hospitals would be taking their "cut" in profits, whereas the government would not do such a thing, acting only in the best interests of the people. Let's attempt to quantify this. Generally, business investments pay off around 10% of their value. That is, if you own $1,000,000 worth of businesses, it will pay you $100,000 per year. Let's compare this 10% premium to the current state of affairs. It has been predicted that healthcare expenses in Canada will soon consume 100% of the current government spending budget. Clearly, this isn't a feasible course of action.

 

2) "Abuse" of the current system

 

Because healthcare in Canada is free, everybody acts in self-interest and demands the best possible treatment for themselves. I'm not saying there is anything immoral about this - when you are at a buffet, you try to eat as much food as possible, because it's free. So "abuse" of the medical care system isn't implied to be malicious in any way.

 

Unfortuneately, the best possible treatment doesn't come cheap. For example, for somebody with cancer, the best possible treatment might cost over a million dollars. When this kind of treatment is given to you for free, you would take it for sure - that's a no brainer. But when you have to pay the $1M out of your pocket, you might think twice about that, and maybe opt for the $100,000 treatment that works 90% as well. This puts unnessessary strain on the system.

 

Here would be a more real-world example of this. Lets say you had to pay $5000 for every day you spend in a hospital bed under a private system, but in a public system it's free for as many days as you like. In the private system, you'd try to clear out of there as quick as you thought you could manage. But in the public system, you'd probably laze around there for as long as you felt like.

 

One could argue that the solution to this, under the public system, would be to appoint officials who decided what kind of treatment you get. How would you feel if somebody declared that your disease isn't worthy enough to receive the level of treatment you believe you deserve? This is in fact similar to the way it is now, but as the strain on the system increases, this problem will be exacerbated. As well, certain levels of treatment are unavailiable for people who would be willing to pay for them. Ultimately, this takes away autonomy from the patient - a fundamental pillar of medical ethics.

 

3) Unions

 

This ties into point #1.

 

Government medicine is more succeptible to unionization. Nobody in government is actively trying to prevent public sector unions... there simply isn't the incentive to do that. A union just means more money from the taxpayers. This makes the system more inefficient.

 

In the private sector, any hospital that becomes unionized would be at a competitive disadvantage, driving it to bankrupcy. This is a big incentive to stop the formation of unions.

 

Sorry if this third section disagrees with your politican ideology, but this is simply the truth.

 

Answers to complaints about a privatized system:

1) Some people can't afford private healthcare

We have medical insurance for that. For a reasonable price, private insurance companies can take care of your medical expenses. In the US, this is about $5000 a year for your family. Considering the average family income is about $40000, this is a reasonable cost. For those who can't afford it, it would probably be more efficient for the government to simply give those families the $5000 for insurance every year, rather than run the whole system itself.

 

2) Everybody should be equal when it comes to healthcare

 

I'm not really sure how this precedent was set. My neibour has a bigger house than me, but you don't see me complaining about that, saying things like "Everybody should be equal when it comes to square footage of houses."

 

Some people value their cars. Some people value their houses. Some people value their health. People should be free to decide how to allocate their funds.

 

One could argue that cars and houses are luxuries, which shouldn't always be equal for everyone, but healthcare is a nessessity, and thus should. This just sounds like sour grapes to me.

 

In practice, what would be different under the private system compared to a government system?

 

- Instead of paying healthcare bills to the government through your taxes, you'd pay to a health insurance company every year. Poor people under the current system are being subsidized, which wouldn't be the case under a private system, where everybody contributes equally. But collectively, the system would cost less, and provide better care to everybody.

 

- The healthcare system as a whole would be lean, mean, and optimized. This is because people out there would lose their jobs (due to bankruptcies of companies) if this didn't happen, where as this is not the case in a public system. This probably means that layers and layers of government would be removed, and about 50000 beaurocrats would lose their jobs.

 

See, nothing big, bad, and scarry about it!

 

TL;DR

 

- Private healthcare = competition = efficiency

- Private healthcare = no unions = efficiency

- Private healthcare = less "abuse" = efficiency

[hking03]

^ no.

 

Just no.

[D.K.]

^ no.

 

Just no.

 

Perhaps you'd like to explain why you disagree?

[A-Stark]

Just one question - since when do patients get to decide when and for how long they're admitted? Certainly hospital services are seldom itching to keep acute care (or any) beds occupied...

[D.K.]

Just one question - since when do patients get to decide when and for how long they're admitted? Certainly hospital services are seldom itching to keep acute care (or any) beds occupied...

 

All I am saying is that if you were paying by the hour, there would be pressure on your part to clear out as fast as possible. That pressure today doesn't exist.

[rmorelan]

All I am saying is that if you were paying by the hour, there would be pressure on your part to clear out as fast as possible. That pressure today doesn't exist.

 

Interesting point but since no one actually wants to be in the hospital there is considerable pressure to leave. Under your plan of private insurance people wouldn't be directly paying either so the you have similarly a lack of financial incentive to exit the system as soon as possible.

[D.K.]

The hospital bed analogy was meant only to illustrate the concept of "abuse" of the system, free from the complication of insurance.

 

In reality, when you buy health insurance, you get a certain amount of coverage. If you want to be insured for the $1,000,000 state of the art cancer treatment, you'll be paying out the nose for that through your premiums. So in this way, people won't be demanding top of the line everything and anything, because they'd have to pay for it indirectly.

 

A more real example could be that if you scraped your knee, you wouldn't go to the hospital, because you know you're not insured for that. If you wanted to see a doctor for your scraped knee, you'd either pay him directly, or through your premiums (in additional coverage... though I'm not quite sure this example is completely appropriate either since you can't insure a scraped knee).

[newmedcraze]

Report button is on the top right above the username (it's the button with the exclamation mark on it). If enough people complain, I'm sure he'll be banned.

 

In addition, I would recommend an IP ban.

 

Like you, I may find his/her opinion extremely right wing. However, I think its illeberal to take away one's right to participate in a public forum due to his/her political belief.

[Wayward son]

In a privatized healthcare industry, the 3 hospitals in town would be competing with each other to drive down costs

 

The vast majority of communities in Canada have a single hospital.

 

We have medical insurance for that. For a reasonable price, private insurance companies can take care of your medical expenses. In the US, this is about $5000 a year for your family. Considering the average family income is about $40000, this is a reasonable cost.

 

Family in Ontario with a single breadwinner:

Income $40,000 - income taxes $6000 (that is before any deductions which would actually be significant in this case). Shifting health care to private insurance might save them $1500 in taxes. Cost of your insurance $5000. They lose about $3500 and in the process gained the joy of fighting with their insurance company which only gives a damn about trying to deny them coverage of every medical procedure they need. You just royally screwed over this family.

 

Family in Ontario with 2 parents each earning $20,000.

Total income $40,000 - total taxes $3900 (again before deductions). You just screwed this family over even more.

 

Every one in a while I start to think that the far right are not as bad as I think they are. Then I once again read what they believe and realize that they are far worse.

 

2) Everybody should be equal when it comes to healthcare

 

I'm not really sure how this precedent was set.

 

It was set in the years after world war II when millions of people fought for the freedoms we enjoy. That kind of thing makes a lot of people realize that there is a fundamental difference between health and say the size of a house or the cost of a car.

[Leon]

I lived in a country where I had to pay for all treatment.

 

It was not nice.

 

Hence:

[D.K.]

Family in Ontario with a single breadwinner:

Income $40,000 - income taxes $6000 (that is before any deductions which would actually be significant in this case). Shifting health care to private insurance might save them $1500 in taxes. Cost of your insurance $5000. They lose about $3500 and in the process gained the joy of fighting with their insurance company which only gives a damn about trying to deny them coverage of every medical procedure they need. You just royally screwed over this family.

 

Family in Ontario with 2 parents each earning $20,000.

Total income $40,000 - total taxes $3500 (again before deductions). You just screwed this family over even more.

 

Every one in a while I start to think that the far right are not as bad as I think they are. Then I once again read what they believe and realize that they are far worse.

 

All I'm going to say is that if you want to tax the rich, then just do it already. There's no need to set up a whole healthcare system as an excuse to redistribute wealth.

 

Alright, so now poor and average families are going to be down $3500 compared to where they were before. Then just find a way to "take back" the money from the rich, problem solved. Happy now, Robbin hood?

 

It was set in the years after world war II when millions of people fought for the freedoms we enjoy. That kind of thing makes a lot of people realize that there is a fundamental difference between health and say the size of a house or the cost of a car.

Don't try to use the halo of WW2 to justify your ideology. It's not like Hitler was fighting to take away everyone's healthcare or something. The men and women who fought and died in WW2 would not approve of you commandeering their efforts to justify your political beliefs. You took this arguement one step too far, this was offensive to me, and many others I'm sure.